Tuesday, October 23, 2018

Ask Anabel: Hair loss and thinning hair

Bob Schulenberg
Anabel Kingsley, a professional trichologist, answers certain questions about the matter of hair that concerns everyone privately as well as personally. 
I have a question regarding post-surgery and the effects of anesthesia on texture of hair and thinning. Both of which I am experiencing following surgery one year ago. Will this be a permanent condition or do you feel it is a matter of time?  Have you heard of this before?Ms. R.

Dear Ms. R,

Hair loss following surgery and general anaesthesia is very common. Depending on the type of the surgery, hair loss can be quite substantial and take a while to settle-down. In terms of a time-line, excessive hair shedding (called telogen effluvium) usually occurs six to twelve weeks after surgery and continues for anywhere from three to six months. That would take you to around four months ago. Therefore, provided the underlying health issue is currently under control, and you have had no other recent illnesses, your hair should have stopped shedding in excess by now — or at least improved. This tells me that there is something else afoot.

It would not surprise me if your hair loss was connected to iron and/or ferritin (stored iron) deficiency. It is very common for these levels to be substantially depleted from blood loss during surgery – and often these levels are not sufficiently increased again. This can have a profound impact on the hair growth cycle, causing increased shedding and the production of shorter and wispier hairs, especially around the temples. The way to rectify low iron and ferritin is with iron supplements.

With all this said, if you had surgery at an age when hair commonly diminishes in diameter naturally (i.e. around menopause), it may simply be that the two have coincided. It could also be that you are contending with all of these aforementioned follicular factors. In any case, there is always a reason for hair loss, and it is almost always improvable.

The first step on your journey to happy hair days is to have blood tests carried-out. Ask your doctor to do a full blood count, making a special request that he or she includes Ferritin, as it is very often left-out! In the meantime, help to optimise your hair’s health from a dietary standpoint. I always instruct my clients to up their intake of protein (the substance hair is made of) at breakfast and lunch. Alongside this, I suggest you take a Protein and Biotin supplement. Doing so will help to bolster the strength of your hair as it grows.
Welcome to the golden years; yeah, right.  My hair has been falling out for about the last 5 years. My mother developed thinning hair in her later years, so I guess it’s heredity. Still, is there anything thing that I can do to at least stop this process? I use Rogaine, wide toothed combs, massage and so on. Any suggestions will be welcomed.Mrs. K.

Dear Mrs. K.,

When you say your hair has been ‘falling out’ for five years, do you mean you are experiencing too much hair fall on a daily basis?  If this is the case, it is usually not a hereditary type of hair loss. It is a ‘telogen effluvium’. This is not genetic and instead is caused by some sort of internal factor — diet, stress, health — you name it. Rogaine will not do much good in this instance. To rectify a telogen effluvium, you must do some investigative work and then embark on a relevant treatment plan. 

From the way you phrased your question, I am going to assume you mean you have been experiencing a gradual reduction in hair volume (aka hair thinning/ Androgenetic Alopecia). So I will concentrate on this. You are right that hair thinning is influenced by genes. However, you shouldn’t necessarily blame your mother; it can be inherited from either side of the family!

Reduced hair volume occurs when certain hair follicles on your scalp are genetically predisposed to be sensitive to normal levels of circulating androgens (male hormones). This sensitivity causes hair follicles to gradually shrink and produce hairs that are slightly finer and shorter with each passing hair growth cycle. This is not usually accompanied by excessive hair fall, although it can be — so best not to rule it out.

In terms of treatment, there is good news! You can definitely slow down a reduction in hair volume. The most effective way to do this is to use topical drops that contain a stimulant and an anti-androgen — the latter of which minimizes the effect that male hormones have on the hair follicle. Rogaine is a good stimulant and should help to a certain degree. However, it does not contain anti-androgens. I recommend using our Tricho 7 scalp drops, which are both stimulating and anti-androgenic.

Apply 2.5mls to the front, top and crown of your scalp daily — preferably after washing your hair. All drops, whether Rogaine or otherwise, must be used daily and on an ongoing basis. If treatment is stopped, hair will return to its original state and continue to deteriorate. I can run into a bit of a road block when I mention this to clients. It can feel like a daunting commitment. However, once I explain that you should think of it as just another step to brushing your teeth, taking only a few seconds, it seems very manageable.

Onto wide-tooth combs! These are excellent in terms of minimizing breakage and wear-and-tear, so please keep using one. However, they will not treat reduced hair volume or hair loss from the follicle. To make your combing experience even more hair friendly, start at your ends and gradually work your way up. Starting at the top can cause snappage. 

When it comes to hair loss of any kind — be it excessive shedding or a gradual thinning — stress management is very important. Stress not only wreaks general havoc on our health, it also messes with our hair growth cycle. If you aren’t doing so already, try out local yoga or Pilates classes, or meditation courses — anything you find relaxing really. Personally, I love to swim.


Do you have a hair or scalp issue you'd like addressed? Ask Anabel.